ONE SOURCE OF ESCALATING AMERICAN HEALTH CARE COSTS IS PHYSICIAN USE OF UNNECESSARY DIAGNOSTIC X-RAYS. INFOMEDICS,INC. HAS DEVELOPED A SET OF COMPUTER-DRIVEN ALGORITHMS THAT CAN PRESCREEN PHYSICIAN ORDERS FOR DIAGNOSTIC IMAGING PROCEDURES AND PROVIDE FEEDBACK TO THE PHYSICIAN ABOUT THE PREDICTED INFORMATION VALUE OF EACH ORDER, THUS ALLOWING THE OPPORTUNITY TO FORE-GO NONPRODUCTIVE PROCEDURES. THE RESULT WILL BE A DECREASE IN HEALTH CARE COSTS WITHOUT COMPROMISING THE QUALITY OF PATIENT CARE. THE GOAL OF THIS PROPOSAL IS TO PURSUE TWO RELATED OBJECTIVES: EVALUATION OF THE CONCEPT OF PRESCREENING OF IMAGING PROCEDURE REQUESTS AND EVALUATION/REFINEMENT OF THE ACTUAL PRODUCT. THE FIRST OBJECTIVE WILL BE ACHIEVED BY INTERVIEWING PERSONNEL IN A VARIETY OF HOSPITALS, FOCUS GROUPS, AND POTENTIAL USERS OF THE SYSTEM. THE SECOND OBJECTIVE WILL BE ACHIEVED BY INSTALLING THE SYSTEM IN A LOCAL HOSPITAL EMERGENCY ROOM AND ASSESSING ITS ACCEPTABILITY, IMPACT ON PHYSICIAN ATTITUDES AND KNOWLEDGE, IMPACT ON PHYSICIAN ORDERING PATTERNS, AND IMPACT ON HOSPITAL COSTS. IF THE PROJECT IS SUCCESSFUL, IT WILL PROVIDE THE OPPORTUNITY FOR HOSPITALS TO CONTROL ONE SEGMENT OF INSTITUTIONAL COSTS BY THE FOCUSED APPLICATION OF A CLINICALLY RELEVANT EDUCATIONAL TOOL.